Functional disability and health-related quality of life among systemic sclerosis patients in Bangladesh

Sigma Hossain; Minhaj Rahim Choudhury; Md Mahmudul Haque; Surayea Yeasmin; Farzana Hossain; Mohammad Mostafa Zaman

doi:10.1186/s41927-022-00291-x

Functional disability and health-related quality of life among systemic sclerosis patients in Bangladesh

BMC Rheumatol. 2022 Sep 30;6(1):60. doi: 10.1186/s41927-022-00291-x.

Authors

Sigma Hossain¹, Minhaj Rahim Choudhury², Md Mahmudul Haque³, Surayea Yeasmin², Farzana Hossain⁴, Mohammad Mostafa Zaman⁵

Affiliations

¹ Department of Rheumatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag Avenue, Dhaka, Bangladesh. sigma_hossain@hms.harvard.edu.
² Department of Rheumatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag Avenue, Dhaka, Bangladesh.
³ Department of Community Medicine, National Institute of Preventive and Social Medicine (NIPSOM), Dhaka, Bangladesh.
⁴ National Institute of Preventive and Social Medicine (NIPSOM), Dhaka, Bangladesh.
⁵ WHO Bangladesh, Dhaka, Bangladesh.

Abstract

Objective: To assess the relationship between functional disability and health-related quality of life (HRQoL) among systemic sclerosis (SSc) patients.

Methodology: This cross-sectional study was carried out on 78 adults who met the classification criteria for SSc defined by the American College of Rheumatology/European League of Rheumatology (ACR/EULAR)-2013. The Bangla version of Short Form 36 (SF-36) and Health Assessment Questionnaire-Disability Index (HAQ-DI) were used to measure HRQoL and functional disability in SSc patients.

Results: The patients' median [IQR] HAQ-DI was 1.4 [0.6-2.1], with 37.2% having a mild functional disability, 33.3 percent having a moderate functional disability, and 29.5 percent having a severe functional disability. The hygiene and activity domains of the HAQ-DI obtained the highest scores, 2.0 [0.0-3.0] and 2.0 [1.0-3.0], respectively. The Physical Component Summary (PCS) and Mental Component Summary (MCS) of the SF-36 had median [IQR] values of 26.2 [15.0-58.1] and 42.0 [19.6-60.6]. The highest score was 50.0 [25.0-75.0] in social functioning. The PCS of the SF-36 was moderately correlated with the HAQ-DI (r_s = - 0.629, P < 0.001) and the MCS of the SF-36 was weakly correlated with the HAQ-DI ((r_s = - 0.344, P < 0.001). Age, female sex, and incomplete fist closure substantially influenced functional status. Calcinosis, Raynaud's Phenomenon, and flexion contracture significantly diminished the quality of life.

Conclusions: Functional disability negatively affects health-related quality of life. Age, Musculoskeletal, and skin involvement are significantly associated with poor quality of life and functional disability. Therefore, treatment strategies should be aimed at reducing functional disability, which will enhance the HRQoL of SSc patients.

Keywords: Functional disability; Health Assessment Questionnaire-Disability Index (HAQ-DI); Health-related quality of life; Short Form 36 (SF-36); Systemic sclerosis.